Menke Jan, Möller Gerhard
Department of Pediatrics, University Hospital Goettingen, Robert-Koch-Strasse 40, 37075, Goettingen, Germany,
Pediatr Cardiol. 2014 Jan;35(1):155-63. doi: 10.1007/s00246-013-0754-9. Epub 2013 Jul 13.
Near-infrared spectroscopy (NIRS) can monitor changes in cerebral regional oxygen saturation (rSO2) and tissue hemoglobin content (HbT). The relation between cerebral NIRS readings and vital parameters has not been analyzed before at a fine temporal scale. This study analyzed this relation during cardiopulmonary bypass (CPB) surgery in 10 children (0-9 years, 1,770 min of data records) by using a novel random-coefficient model. The analysis indicated that a small number of patients is sufficient for obtaining significant results with this model. Changes of vital parameters explained 84.7 % of rSO2 changes and 90.7 % of HbT changes. Cerebral rSO2 correlated positively with perfusion pressure and inversely with body temperature (P < 0.05). Cerebral HbT correlated positively with perfusion pressure, central venous pressure, and temperature and inversely with arterial oxygen saturation (P < 0.05). During hypothermic circulatory arrest, the half-life of the exponential rSO2 decay correlated to the rSO2 reserve (P = 0.016). In conclusion, NIRS readings of cerebral hemoglobin content and tissue oxygen saturation correlate well to vital parameters during CPB surgery in children. NIRS may therefore become a monitoring device for the neuroprotective optimization of those vital parameters.
近红外光谱（NIRS）可监测脑局部氧饱和度（rSO2）和组织血红蛋白含量（HbT）的变化。此前尚未在精细的时间尺度上分析过脑NIRS读数与生命体征参数之间的关系。本研究通过使用一种新型随机系数模型，对10名儿童（0 - 9岁，1770分钟的数据记录）在体外循环（CPB）手术期间的这种关系进行了分析。分析表明，对于该模型而言，少量患者就足以获得显著结果。生命体征参数的变化解释了84.7%的rSO2变化和90.7%的HbT变化。脑rSO2与灌注压呈正相关，与体温呈负相关（P < 0.05）。脑HbT与灌注压、中心静脉压和体温呈正相关，与动脉血氧饱和度呈负相关（P < 0.05）。在低温循环停搏期间，指数rSO2衰减的半衰期与rSO2储备相关（P = 0.016）。总之，在儿童CPB手术期间，脑血红蛋白含量和组织氧饱和度的NIRS读数与生命体征参数密切相关。因此，NIRS可能成为用于对这些生命体征参数进行神经保护优化的监测设备。
